Early Clinical Presentations And MRI Characteristics In Newborns With Cerebral Infarction

ObjectiveMagnetic resonance imaging(MRI) is the gold standard for the diagnosis of neonatal cerebral infarction(NCI) at present.Conventional MRI is not sensitive for the detection of stroke in the early stage.The aim of this study was to characterize the clinical presentations and imaging findings in conventional MRI and diffusion-weighted MR imaging(DWI) caused by NCI,which might be useful for the early diagnosis.MethodsConventional MRI,diffusion-weighted imaging and clinical data from 16 neonates with NCI were retrospectively reviewed.All cases underwent DWI in addition to conventional MR imaging(T1-weighted[T1W]and T2-weighted[T2W]) within first 5 days,5 of whom repeated the imaging at the age of 11 days to 17 days.Results1,Risk factors:antenatal risk factors(n=8);intranatal risk factors(n=9);postnatal risk factors(n=0).Clinical presentations:seizure was the first symptom in 11 neonates;2,early imaging(within 5 days):slightly hypointensity on T1W,slightly hyperintensity on T2W and significantly increased signal intensity with the clear boundary on DWI in the lesions;late imaging:Compared with the early imaging,more obviously hypointensity on T1W and hyperintensity on T2W,while hypointensity was shown on DWI.Conclusion1,Seizures characterized the low frequency and slight severity may be the first symptom for NCI.2,Firstly,it is the abnormal imaging finding that significantly increased signal intensity in the lesions was showed on DWI in the early stage;then hypointensity on T1W and hyperintensity on T2W,which are increasing abnormal over time particularly on T2W.